Zusammenfassung
Die Regionalanästhesie besitzt in der Orthopädie/Traumatologie als Anästhesieverfahren einen hohen Stellenwert. Die Anwendung von Kathetertechniken ermöglicht zudem eine effektive postoperative Schmerztherapie. In den letzten Jahren hat sich die ultraschallgesteuerte Regionalanästhesie als Ergänzung zur landmarkengestützten Anlagetechnik mit Nervenstimulation etabliert. Ultraschallgeräte mit hochfrequenten Sonden ermöglichen die Darstellung peripherer Nerven und der umliegenden anatomischen Strukturen. In Echtzeit kann der Anästhesist die Annäherung der Punktionskanüle an die Nervenstrukturen und die Ausbreitung des Lokalanästhetikums im Gewebe verfolgen. Vielfach belegt wurden die höhere Erfolgsquote und der geringere Zeitbedarf zur Durchführung der Anästhesie im Vergleich zu konventionellen Techniken. Somit trägt die Sonographiesteuerung dazu bei, dass sich die Regionalanästhesie im prozessorientierten orthopädisch/traumatologischen OP zu einer noch effektiveren und besser planbaren Anästhesiemethode entwickelt.
Abstract
Regional anaesthesia is considered to be an important method of anesthesia in orthopedic surgery and the use of catheter techniques improves postoperative pain management. In recent years ultrasound-guided regional anesthesia has become established in addition to landmark-controlled placement with nerve stimulation. Ultrasound devices featuring high frequency probes allow on-site imaging of peripheral nerves and other important anatomic structures. Moreover the cannula approaching the nerves and the distribution of the local anesthetic can be visualized in real-time. Higher success rates and shorter block times compared to conventional techniques have been shown in several trials. Thus ultrasound-guided placement promotes the use of regional anesthesia as a more effective and more reliable method for orthopedic surgery.
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Notheisen, T., Eichholz, R., Ruppert, E. et al. Ultraschallgesteuerte Regionalanästhesie in der Orthopädie/Traumatologie. Trauma Berufskrankh 12, 128–133 (2010). https://doi.org/10.1007/s10039-010-1633-8
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DOI: https://doi.org/10.1007/s10039-010-1633-8